$86 Billion Spent on Back, Neck Pain

The Cost of Treating Back Pain continued...

Martin tells WebMD that the 65% inflation-adjusted increase in total costs
among adults with spine problems was higher than the increase in health costs
overall.

"We are spending as much on spine problems as we do for cancer and
arthritis," he says. "The only disease category that dwarfs these is
heart disease and
stroke. If we are spending more on diagnosis and treatment, we should
expect to see health status changes that are commensurate with that investment.
But that is not what we are seeing."

Steep Rise in Drug Costs

Some of the largest increases have been in expenditures related to drug
treatments, Martin says.

Overall, pharmaceutical expenditures related to back and neck pain increased
by 188% between 1997 and 2005, but cost associated with prescription narcotics
rose by a whopping 423%.

University of Washington Medical Center clinician Richard Deyo, MD, MPH,
tells WebMD that increasing use of the newer narcotics such as the drugs
Vicodin and
OxyContin is largely responsible for the increase, even though their use
for chronic pain is controversial.

He says patients need to recognize that the drugs have many potential side
effects, including drowsiness, persistent
constipation, and sexual dysfunction.

Deyo co-directs the University of Washington Center for Cost and Outcomes
Research, and he was a co-author of the study.

"We still don't know much about their long-term efficacy and safety for
chronic back pain," he says. "Patients need to understand that if they
take these (opioid) medications long term, after a few months it will be
difficult to stop. And there is pretty good evidence that long-term use may
actually increase sensitivity to pain."

Too Much Surgery?

Surgery, especially
spinal fusion surgery or disc replacement surgery, is also a growing and
somewhat controversial treatment for patients with chronic back pain without
sciatica.

"An aggressive arm of the surgical community believes that these
patients benefit from surgery, but this is an area where the evidence is at
best murky and confusing," Deyo says.

Orthopedic surgeon Paul Rubery,
MD, agrees that the benefits of surgery are questionable in this group of
patients.